A congressional effort to stiffen regulations on pharmacy benefit managers may not be dead after all.
Senate Finance Committee Chair Ron Wyden (D-Ore.) and ranking member Mike Crapo (R-Idaho) aim to attach measures their panel has already approved to a spending bill Congress must pass by next Friday to avoid a partial government shutdown, they said at a Capitol Hill news conference Thursday.
Related: PBM reform advocates hold out hope for congressional action
"We're going to be pulling out all the stops," Wyden said. "We want to put patients over profits and pass PBM reforms into the law. We're going to stay at it until it gets done. No ifs, ands or buts, because the longer Congress waits, the more families hurt, the more they have to pony up extra dollars."
Wyden said he's advised Senate leadership and the rest of the Finance Committee that he wants PBM legislation included in the upcoming spending bill, which also will include appropriations for the Health and Human Services Department. That measure must reach President Joe Biden by March 22 to avoid disruptions in government operations.
"Sen. Wyden and I are committed to getting these reforms across the finish line to deliver much needed reform for Americans as soon as possible," Crapo said.
National Association of Chain Drug Stores President and CEO Steven Anderson and National Community Pharmacists Association CEO Doug Hoey participated in the news conference and brought along hundreds of pharmacists to support the legislative effort.
The Pharmaceutical Care Management Association, which represents PBMs, opposes all of the bills.
“The Big Pharma-backed PBM legislation in Congress does absolutely nothing to reduce prescription drug costs for patients and strips employers and unions of the choice and flexibility they need to design low-cost quality pharmacy benefits to working families," PCMA said in a statement Thursday.
Last year, the Finance Committee and the Senate Health, Education, Labor and Pensions Committee advanced bipartisan bills to govern PBM business practices and inject greater transparency into pharmaceutical pricing. The House overwhelmingly passed the Lower Costs More Transparency Act of 2023 in December.
But these congressional leaders abandoned these bills amid disagreements between House and Senate lawmakers about the details.
The Finance Committee bills — the Modernizing and Ensuring PBM Accountability Act of 2023 and the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 — would ban spread pricing and institute new transparency rules for PBMs doing business with government programs such as Medicare and Medicaid. The House-passed legislation has similar aims and scope.
The HELP Committee's Pharmacy Benefit Manager Reform Act of 2023 has the furthest reach because it would apply to PBMs in the private health insurance market.
Although all of these bills have proven popular in Congress, Wyden and Crapo will again have to navigate the same issues that held up progress just weeks ago. "I don't get into the details of negotiations, but there are extensive talks going on," Crapo said after the news conference.
The House may be more amenable to the Finance Committee legislation over the broader HELP Committee measure, House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) said last week. That committee unanimously approved the Lower Costs More Transparency Act last May.
But HELP Committee members may press their case, said Sens. Dr. Roger Marshall (R-Kan.) and Mike Braun (R-Idaho), who both sit on the panel.
"I've not given up yet. And the [GOP Doctors Caucus] has not given up yet," Marshall said after leaders removed PBM legislation from the previous spending package this month. "The cost of prescription drugs is one of the top concerns for folks back home, and I'm going to do everything I can."
